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A Presidential Challenge

By Michael R. Fraser, PhD CAE

Prematurity prevention has gained a great deal of national attention over the past few years thanks to a number of efforts by Title V programs and other partners, including the March of Dimes. Indeed, by the time this issue of Pulse hits your inbox, the March of Dimes will have released the latest set of state-based prematurity report cards that show some progress to celebrate in reducing premature births nationwide, but also a great deal more we can do to address prematurity. Most recently, the issue of prematurity prevention was highlighted by the president of the Association of State and Territorial Health Officials (ASTHO), Dr. David Lakey, Texas State Health Commissioner, who challenged all states to attempt to reduce prematurity rates by 8 percent in their states over the next two years (see Feature "Interview with Dr. David Lakey, MD, Commissioner of Health, Texas Department of State Health Services on the ASTHO Healthy Babies Presidential Challenge" on page 5).

There is a lot we know about how to address the issue of premature birth. Many partners have shared their recommendations on how to best support efforts to reduce preventable preterm births. There are counseling interventions, clinical interventions, including pharmacological interventions, community interventions, and policy interventions. We know what will drive the prematurity rate down, but what’s the Title V/MCH program role in this?

Obviously there are many roles for state Title V programs in addressing prematurity, and all states have a history of working on prematurity prevention. But perhaps the most significant role Title V can play is coordinating and leading state efforts to address this important issue. Given the number of players, the areas for intervention, and the attention to prematurity prevention, state Title V programs can certainly bring value to coordinating efforts and collaborating across sectors to support interventions that will reduce preterm birth. Leadership is another contribution of state Title V programs. The broad Title V mandate to address the needs of all women and children, with a focus on vulnerable populations, makes it the logical place to lead and coordinate efforts statewide. In addition, the fact that every state reports on performance measures related to prematurity means states are accountable for addressing this issue as part of their work supported through the Title V MCH Services Block Grant.

Leadership, coordination, collaboration. These are hallmarks of state MCH systems. State Title V programs are in an ideal position to leverage all available resources, including scientific, programmatic and policy interventions and recommendations, to meet Dr. Lakey’s challenge of reducing preterm birth rates by 8 percent. Do you think you can do it? The Challenge is there: let us know how your state is responding!